[The relationships of rapidly progressive glomerulonephritis (RPGN), crescentic glomerulonephritis and vasculitis: the clinical, histopathological and therapeutic considerations].
Rapidly progressive glomerulonephritis (RPGN) is a rare but severe condition, with a particular poor outcome in the absence of aggressive therapy. Our study describes all RPGN consecutive cases treated during the 1994-1995 period, with special interest in revealing negative prognostic features at presentation and the optimum therapeutic strategy. 14 (20% of all ARF for the same period) cases were classified as RPGN. Although rare (30%), extrarenal symptoms were related with a more unfavourable course. Creatinine clearance at presentation was not a reliable prognostic factor in our study. ANCA was found in 86% of our patients (p-ANCA/c-ANCA = 2/1), and therapeutic success was associated with ANCA disappearance. Crescentic glomerulonephritis was seen in 93% of all cases 77% of which were type III, pauciimune, ANCA positive. Vasculitic lesions and fibrous crescents, but not % of glomerular circumference or % of affected glomeruli were also related with a poor prognosis. Only 43% of our RPGN cases survived with a normal renal function. i.v. metil-prednisolone (at presentation, as soon as possible) followed by i.v. cyclophosphamide up to six months was the best therapeutic regimen, with no important side-effects.
Covic
A
A
Clinica a IV-a Medicală--Nefrologie, Universitatea de Medicină şi Farmacie Gr. T. Popa, Iaşi.
Marian
D
D
Florea
L
L
Mititiuc
I
I
Căruntu
I
I
Cotuţiu
C
C
Covic
M
M
D000208:Acute Disease; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D005921:Glomerulonephritis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000473:pathology; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D014657:Vasculitis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology
Relaţia glomerulonefrită rapid progresivă (GNRP)--glomerulonefrită crescentică--vasculita: consideraţii clinice, histopatologice şi terapeutice.